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2017 ; 13
(6
): 2599-2608
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Distribution characteristics of Staphylococcus spp in different phases of
periprosthetic joint infection: A review
#MMPMID28587320
Guo G
; Wang J
; You Y
; Tan J
; Shen H
Exp Ther Med
2017[Jun]; 13
(6
): 2599-2608
PMID28587320
show ga
Periprosthetic joint infection (PJI) is a devastating condition and
Staphylococcus spp. are the predominant pathogens responsible, particularly
coagulase-negative staphylococci (CoNS) and Staphylococcus aureus. The aim of the
present systematic review was to evaluate the distribution characteristics of
specific Staphylococcus spp. in different PJI phases, reveal the effect of
pathogens' feature on their distribution and suggest recommendations for
antibiotic treatment of Staphylococcal PJI. The present systematic review was
performed using PubMed and EMBASE databases with the aim to identify existing
literature that presented the spectrum of Staphylococcus spp. that occur in PJI.
Once inclusion and exclusion criteria were applied, 20 cohort studies involving
3,344 cases in 3,199 patients were included. The predominant pathogen involved in
PJI was indicated to be CoNS (31.2%), followed by S. aureus (28.8%). This trend
was more apparent in hip replacement procedures. In addition, almost equal
proportions of CoNS and S. aureus (28.6 and 30.0%, respectively) were indicated
in the delayed phase. CoNS (36.6%) were the predominant identified organism in
the early phase, whereas S. aureus (38.3%) occurred primarily in the late phase.
In PJI caused by S. aureus, the number of cases of methicillin-sensitive
Staphylococcus aureus (MSSA) was ~2.5-fold greater than that of
methicillin-resistant Staphylococcus aureus (MRSA). MRSA occurred predominantly
in the early phase, whereas MSSA was largely observed in the delayed and late
phases. With regards to antibiotic treatment, the feature of various pathogens
and the phases of PJI were the primary considerations. The present review
provides useful information for clinical practice and scientific research of PJI.